Lay summary
Abortion law reform and the Covid19 pandemic response in New Zealand changed provision of abortion care overnight. The proportion of abortions being performed medically rather than surgically has increased, as has abortion provided via telehealth. An unintended consequence is fewer woman received contraception. The current knowledge gap is the best method of follow up after early medical abortion. But what constitutes ‘good’ follow-up? It needs to be effective at detecting ongoing pregnancy, be woman-centred and acceptable, enable women to plan their next pregnancy, and be cost-effective. In most New Zealand abortion services, current follow up is a clinician checking the pregnancy hormone serum level has decreased appropriately. We propose an innovative follow up method of self-assessment, using a simple inexpensive home urine pregnancy self-test, alongside resources for counselling, contraception, etc. If this study finds that self-assessment is effective, safe, cost effective and preferred by women, this could change practice nationally.